SAFE Health (Secure Architecture For Exchanging Health Information) is a project to create a Local Heath Information Infrastructure (LHII) for the patients, healthcare providers, payers and public health agencies in central Massachusetts. Using nationally accepted data exchange standards and a federated, decentralized approach to authentication, master person index and data repositories, SAFE Health will create a secure, scalable and sustainable model that can be replicated and interfaced to other LHII's. The system uses innovative approaches to integrate with the varied workflows of clinicians in a timely manner and is designed to assist in communication among patients, healthcare providers, and public health monitoring organizations. Unique to SAFE Health is the integration of decision support directly into the network infrastructure. SAFE Health's implementation and refinement will be managed by a not-for-profit organization with representation from all major stakeholders, including patients, clinicians and public health agencies. The long-term goals of SAFE Health include improving healthcare quality and safety while reducing healthcare costs nationwide. Specific measurable aims include: 1) creation and validation of a sustainable technical, organizational and financial model for LHII's; 2) demonstrate clinician and patient acceptance and use of an LHII; 3) improve community-level compliance with health maintenance and disease management tests and procedures; 4) empower patients to become more involved in their healthcare; 5) provide a mechanism to automatically monitor patient safety and public health through sentinel events; 6) demonstrate a reduction in adverse events; 7) quantify a reduction in healthcare costs through decreased utilization and improved process efficiencies; 8) facilitate the implementation of Electronic Health Records (EHR's); 9) disseminate lessons learned in order to encourage the creation of other LHII's; and 10) demonstrate data exchange with other LHII's as a model for the Nation Health Information Infrastructure (NHII).